(consumption)--and the greatest care should be exercised to avoid exposure to the wet or to cold draughts. =GERMAN MEASLES= (_Roetheln_).--German measles is related neither to measles nor scarlet fever, but resembles them both to a certain extent--more closely the former in most cases. It is a distinct disease, and persons who have had both measles and scarlet fever are still susceptible to German measles. One attack of German measles usually protects the patient from another. Adults, who have not been previously attacked, are almost as liable to German measles as children, but it is rare that infants acquire the disease. It is a very contagious disorder--but not so much so as true measles--and often occurs in widespread epidemics. The breath and emanations from the skin transmit the _contagium_ from the appearance of the first symptom to the disappearance of the eruption. =Development.=--The period elapsing after exposure to German measles and before the appearance of the symptoms varies greatly--usually about two weeks; it may vary from five to eighteen days. =Symptoms.=--The rash may be the first sign of the disease and more frequently is so in children. In others, for a day or two preceding the eruption, there may be headache, soreness, and redness of the throat, the appearance of red spots on the upper surface of the back of the mouth, chilliness, soreness in the muscles, loss of appetite, watering of the eyes. Catarrhal symptoms are most generally absent, an important point in diagnosis. When present, they are always mild. These preliminary symptoms, if present, are much milder and of shorter duration than in measles, where they last for four days before the rash appears; and the hard, persistent cough of measles is absent in German measles. Also, while there is sore throat in the latter, there is not the severe form with swollen tonsils covered with white spots so often seen in scarlet fever. Fever is sometimes absent in German measles; usually it ranges about 100 deg. F., rarely over 102 deg. F. Thus, German measles differs markedly from both scarlet fever and measles proper. The rash usually appears first on the face, then on the chest, and finally covers the whole body, in the space of a few hours--twenty-four hours at most. The eruption takes the form of rose-red, round or oval, slightly raised spots--from the size of a pin head to that of a pea--sometimes running together into uniform redness, as in scarlet fever. The rash remains fully developed for about two days, and often changes into a coppery hue as it gradually fades away. There are often lumps--enlarged glands--to be felt under the jaw, on the sides and back of the neck, which occur more commonly in German than in true measles. The glands at the back of the neck are the most characteristic. They are enlarged in about two-thirds of the cases.